Language Deficit

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Vivek Prabhakaran - One of the best experts on this subject based on the ideXlab platform.

Zoe Woodhead - One of the best experts on this subject based on the ideXlab platform.

  • how does ireadmore therapy change the reading network of patients with central alexia
    The Journal of Neuroscience, 2019
    Co-Authors: Sheila J Kerry, Zoe Woodhead, Oscar M Aguilar, Alexander P Leff, William D Penny, Jennifer T Crinion
    Abstract:

    Central alexia (CA) is an acquired reading disorder co-occurring with a generalized Language Deficit (aphasia). The roles of perilesional and ipsilesional tissue in recovery from poststroke aphasia are unclear. We investigated the impact of reading training (using iReadMore, a therapy app) on the connections within and between the right and left hemisphere of the reading network of patients with CA. In patients with pure alexia, iReadMore increased feedback from left inferior frontal gyrus (IFG) region to the left occipital (OCC) region. We aimed to identify whether iReadMore therapy was effective through a similar mechanism in patients with CA. Participants with chronic poststroke CA (n = 23) completed 35 h of iReadMore training over 4 weeks. Reading accuracy for trained and untrained words was assessed before and after therapy. The neural response to reading trained and untrained words in the left and right OCC, ventral occipitotemporal, and IFG regions was examined using event-related magnetoencephalography. The training-related modulation in effective connectivity between regions was modeled at the group level with dynamic causal modeling. iReadMore training improved participants' reading accuracy by an average of 8.4% (range, -2.77 to 31.66) while accuracy for untrained words was stable. Training increased regional sensitivity in bilateral frontal and occipital regions, and strengthened feedforward connections within the left hemisphere. Our data suggest that iReadMore training in these patients modulates lower-order visual representations, as opposed to higher-order, more abstract representations, to improve word-reading accuracy.SIGNIFICANCE STATEMENT This is the first study to conduct a network-level analysis of therapy effects in participants with poststroke central alexia. When patients trained with iReadMore (a multimodal, behavioral, mass practice, computer-based therapy), reading accuracy improved by an average 8.4% on trained items. A network analysis of the magnetoencephalography data associated with this improvement revealed an increase in regional sensitivity in bilateral frontal and occipital regions and strengthening of feedforward connections within the left hemisphere. This indicates that in patients with CA iReadMore engages lower-order, intact resources within the left hemisphere (posterior to their lesion locations) to improve word reading. This provides a foundation for future research to investigate reading network modulation in different CA subtypes, or for sentence-level therapy.

  • randomized trial of ireadmore word reading training and brain stimulation in central alexia
    Brain, 2018
    Co-Authors: Zoe Woodhead, Sheila J Kerry, Oscar M Aguilar, Yeanhoon Ong, John Hogan, Katerina Pappa, Alexander P Leff
    Abstract:

    Central alexia is an acquired reading disorder co-occurring with a generalized Language Deficit (aphasia). We tested the impact of a novel training app, 'iReadMore', and anodal transcranial direct current stimulation of the left inferior frontal gyrus, on word reading ability in central alexia. The trial was registered at www.clinicaltrials.gov (NCT02062619). Twenty-one chronic stroke patients with central alexia participated. A baseline-controlled, repeated-measures, crossover design was used. Participants completed two 4-week blocks of iReadMore training, one with anodal stimulation and one with sham stimulation (order counterbalanced between participants). Each block comprised 34 h of iReadMore training and 11 stimulation sessions. Outcome measures were assessed before, between and after the two blocks. The primary outcome measures were reading ability for trained and untrained words. Secondary outcome measures included semantic word matching, sentence reading, text reading and a self-report measure. iReadMore training resulted in an 8.7% improvement in reading accuracy for trained words (95% confidence interval 6.0 to 11.4; Cohen's d = 1.38) but did not generalize to untrained words. Reaction times also improved. Reading accuracy gains were still significant (but reduced) 3 months after training cessation. Anodal transcranial direct current stimulation (compared to sham), delivered concurrently with iReadMore, resulted in a 2.6% (95% confidence interval -0.1 to 5.3; d = 0.41) facilitation for reading accuracy, both for trained and untrained words. iReadMore also improved performance on the semantic word-matching test. There was a non-significant trend towards improved self-reported reading ability. However, no significant changes were seen at the sentence or text reading level. In summary, iReadMore training in post-stroke central alexia improved reading ability for trained words, with good maintenance of the therapy effect. Anodal stimulation resulted in a small facilitation (d = 0.41) of learning and also generalized to untrained items.10.1093/brain/awy138_video1awy138media15796149281001.

Oscar M Aguilar - One of the best experts on this subject based on the ideXlab platform.

  • how does ireadmore therapy change the reading network of patients with central alexia
    The Journal of Neuroscience, 2019
    Co-Authors: Sheila J Kerry, Zoe Woodhead, Oscar M Aguilar, Alexander P Leff, William D Penny, Jennifer T Crinion
    Abstract:

    Central alexia (CA) is an acquired reading disorder co-occurring with a generalized Language Deficit (aphasia). The roles of perilesional and ipsilesional tissue in recovery from poststroke aphasia are unclear. We investigated the impact of reading training (using iReadMore, a therapy app) on the connections within and between the right and left hemisphere of the reading network of patients with CA. In patients with pure alexia, iReadMore increased feedback from left inferior frontal gyrus (IFG) region to the left occipital (OCC) region. We aimed to identify whether iReadMore therapy was effective through a similar mechanism in patients with CA. Participants with chronic poststroke CA (n = 23) completed 35 h of iReadMore training over 4 weeks. Reading accuracy for trained and untrained words was assessed before and after therapy. The neural response to reading trained and untrained words in the left and right OCC, ventral occipitotemporal, and IFG regions was examined using event-related magnetoencephalography. The training-related modulation in effective connectivity between regions was modeled at the group level with dynamic causal modeling. iReadMore training improved participants' reading accuracy by an average of 8.4% (range, -2.77 to 31.66) while accuracy for untrained words was stable. Training increased regional sensitivity in bilateral frontal and occipital regions, and strengthened feedforward connections within the left hemisphere. Our data suggest that iReadMore training in these patients modulates lower-order visual representations, as opposed to higher-order, more abstract representations, to improve word-reading accuracy.SIGNIFICANCE STATEMENT This is the first study to conduct a network-level analysis of therapy effects in participants with poststroke central alexia. When patients trained with iReadMore (a multimodal, behavioral, mass practice, computer-based therapy), reading accuracy improved by an average 8.4% on trained items. A network analysis of the magnetoencephalography data associated with this improvement revealed an increase in regional sensitivity in bilateral frontal and occipital regions and strengthening of feedforward connections within the left hemisphere. This indicates that in patients with CA iReadMore engages lower-order, intact resources within the left hemisphere (posterior to their lesion locations) to improve word reading. This provides a foundation for future research to investigate reading network modulation in different CA subtypes, or for sentence-level therapy.

  • randomized trial of ireadmore word reading training and brain stimulation in central alexia
    Brain, 2018
    Co-Authors: Zoe Woodhead, Sheila J Kerry, Oscar M Aguilar, Yeanhoon Ong, John Hogan, Katerina Pappa, Alexander P Leff
    Abstract:

    Central alexia is an acquired reading disorder co-occurring with a generalized Language Deficit (aphasia). We tested the impact of a novel training app, 'iReadMore', and anodal transcranial direct current stimulation of the left inferior frontal gyrus, on word reading ability in central alexia. The trial was registered at www.clinicaltrials.gov (NCT02062619). Twenty-one chronic stroke patients with central alexia participated. A baseline-controlled, repeated-measures, crossover design was used. Participants completed two 4-week blocks of iReadMore training, one with anodal stimulation and one with sham stimulation (order counterbalanced between participants). Each block comprised 34 h of iReadMore training and 11 stimulation sessions. Outcome measures were assessed before, between and after the two blocks. The primary outcome measures were reading ability for trained and untrained words. Secondary outcome measures included semantic word matching, sentence reading, text reading and a self-report measure. iReadMore training resulted in an 8.7% improvement in reading accuracy for trained words (95% confidence interval 6.0 to 11.4; Cohen's d = 1.38) but did not generalize to untrained words. Reaction times also improved. Reading accuracy gains were still significant (but reduced) 3 months after training cessation. Anodal transcranial direct current stimulation (compared to sham), delivered concurrently with iReadMore, resulted in a 2.6% (95% confidence interval -0.1 to 5.3; d = 0.41) facilitation for reading accuracy, both for trained and untrained words. iReadMore also improved performance on the semantic word-matching test. There was a non-significant trend towards improved self-reported reading ability. However, no significant changes were seen at the sentence or text reading level. In summary, iReadMore training in post-stroke central alexia improved reading ability for trained words, with good maintenance of the therapy effect. Anodal stimulation resulted in a small facilitation (d = 0.41) of learning and also generalized to untrained items.10.1093/brain/awy138_video1awy138media15796149281001.

Thomas Picht - One of the best experts on this subject based on the ideXlab platform.

  • p024 hemispheric Language dominance measured by rtms and postoperative course of Language function in brain tumor patients
    Clinical Neurophysiology, 2017
    Co-Authors: Sebastian Ille, Nataliia Kulchytska, Nico Sollmann, Regina Wittig, Eva Beurskens, Vicki M Butenschoen, Florian Ringel, Peter Vajkoczy, Bernhard Meyer, Thomas Picht
    Abstract:

    Introduction The resection of left-sided perisylvian brain lesions harbors the risk of postoperative aphasia. Because it is known that Language function can shift between hemispheres in brain tumor patients, the preoperative knowledge of the patient’s Language dominance could be helpful. Objective To investigate the correlation of hemispheric Language dominance as measured by repetitive navigated transcranial magnetic stimulation (rTMS) and surgery-related Deficits of Language function. Patients & methods We pooled the bicentric Language mapping data of 80 patients undergoing the resection of left-sided perisylvian brain lesions in our two university neurosurgical departments. We calculated error rates (ERs; ER = errors per stimulations) for both hemispheres and defined the hemispheric dominance ratio (HDR) as the quotient of the left- and right-sided ER (HDR > 1 = left dominant; HDR 1 = right dominant). The course of the patient’s Language function was evaluated and correlated with the preoperative HDR. Result Only three of 80 patients (4%) presented with permanent surgery-related aphasia and 24 patients (30%) with transient surgery-related aphasia. The mean HDR (±standard deviation) of patients with new aphasia after five days was significantly higher (1.68 ± 1.07) than the HDR of patients with no new Language Deficit (1.37 ± 1.08) (p = 0.0482). With a predefined cut-off value of 0.5 for HDR, we achieved a sensitivity for predicting new aphasia of 100%. Conclusion A higher preoperative HDR significantly correlates with an increased risk for transient aphasia. Moreover, the intensive preoperative workup in this study led to a considerably low rate of permanent aphasia.

  • hemispheric Language dominance measured by repetitive navigated transcranial magnetic stimulation and postoperative course of Language function in brain tumor patients
    Neuropsychologia, 2016
    Co-Authors: Sebastian Ille, Nataliia Kulchytska, Nico Sollmann, Regina Wittig, Eva Beurskens, Vicki M Butenschoen, Florian Ringel, Peter Vajkoczy, Bernhard Meyer, Thomas Picht
    Abstract:

    Abstract Object The resection of left-sided perisylvian brain lesions harbors the risk of postoperative aphasia. Because it is known that Language function can shift between hemispheres in brain tumor patients, the preoperative knowledge of the patient's Language dominance could be helpful. We therefore investigated the hemispheric Language dominance by repetitive navigated transcranial magnetic stimulation (rTMS) and surgery-related Deficits of Language function. Methods We pooled the bicentric Language mapping data of 80 patients undergoing the resection of left-sided perisylvian brain lesions in our two university neurosurgical departments. We calculated error rates (ERs; ER = errors per stimulations) for both hemispheres and defined the hemispheric dominance ratio (HDR) as the quotient of the left- and right-sided ER (HDR >1= left dominant; HDR Results Only three of 80 patients (4%) presented with permanent surgery-related aphasia and 24 patients (30%) with transient surgery-related aphasia. The mean HDR (± standard deviation) of patients with new aphasia after five days was significantly higher (1.68±1.07) than the HDR of patients with no new Language Deficit (1.37±1.08) (p=0.0482). With a predefined cut-off value of 0.5 for HDR, we achieved a sensitivity for predicting new aphasia of 100%. Conclusion A higher preoperative HDR significantly correlates with an increased risk for transient aphasia. Moreover, the intensive preoperative workup in this study led to a considerably low rate of permanent aphasia.

Rosaleena Mohanty - One of the best experts on this subject based on the ideXlab platform.

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